oral pathology review questions - Alabama Board of Dental Examiners

ORAL PATHOLOGY REVIEW QUESTIONS:
1. Bruxism is a pathologic manifestation of which of the following conditions?
a. Erosion
b. Attrition
c. Abrasion
d. Abfraction
2. Hairy tongue is characterized by hyperplasia of which of the following papillae?
a. Foliate
b. Filiform
c. Fungiform
d. Circumvallate
3. A debilitated patient on oral penicillin has white lesions that can be stripped away from
the tongue, leaving a raw surface. This patient probably has:
a. candidiasis.
b. lichen planus.
c. mucosal dysplasia.
d. erythema multiforme.
4. A 50-year-old woman is examined in a dental office. She smokes, is sensitive to sunlight, and has had basal cell carcinoma of the lower lip. She has a medical history of
intestinal polyps and has had a hysterectomy. Upon dental clinical examination, she is
found to have yellow elevated areas on the mucosa of her lower lip and on her buccal
mucosa, bilaterally. She is not aware of the presence of these yellow elevated areas. This
patient most probably has, from a dental point of view:
a. candidiasis.
b. Fordyce granules.
c. nicotinic stomatitis.
d. lupus erythematosis.
5. Epulis fissuraturm in the oral cavity is most commonly caused by:
a. smoking.
b. candidiasis.
c. poor oral hygiene.
d. ill-fitting dentures.
6. The state of teeth joined together only by cementum is diagnosed as:
a. fusion.
b. budding.
c. gemination.
d. concrescence.
ADHP Oral Pathology 2015 1 7. Two tooth buds are joined together during development and may appear clinically as a
macrodont. The probable diagnosis is:
a. fusion.
b. budding.
c. gemination.
d. concrescence.
8. A radiograph shows that the roots of a lower molar are severely curved to almost 90
degrees. This is diagnosed as:
a. hypoplasia.
b. dilaceration.
c. Turner's tooth.
d. Hutchinson's tooth.
9. Which of the following is the most common site for a supernumerary tooth?
a. Distal to the maxillary third molar
b. Distal to the mandibular third molar
c. Between the mandibular bicuspids
d. Between the maxillary central incisors
10. A patient has lost enamel on the anterior teeth because of a lemon-sucking habit. The
diagnosis is:
a. erosion.
b. attrition.
c. abrasion.
d. chemico-attrition.
11. A grayish-white, thickened, multinodular papular appearance of the palate with a small
red spot in the center of each nodule, found only in smokers, describes which of the
following conditions?
a. Candidiasis
b. Leukoplakia
c. Nicotine stomatitis
d. Papillary hyperplasia
12. A grayish-white area with a coarsely wrinkled appearance, found bilaterally on the
buccal mucosa of a black patient, is probably:
a. leukoplakia.
b. leukoedema.
c. lichen planus.
d. lupus erythematosus.
13. Oral squamous cell carcinoma is most commonly found at the following sites:
a. hard and soft palate.
b. gingiva and alveolar ridge.
c. buccal mucosa and mucobuccal fold.
d. lateral tongue and floor of the mouth.
14. Identify the three conditions in which the papillomavirus has been found?
a. Oral papilloma
b. Papillary hyperplasia
c. Condyloma acuminatum
d. Squamous cell carcinoma
15. For each of the herpes viruses listed below, select its associated disease process.
Virus
Disease
__ 1. Epstein-Barr virus
a. Shingles
__ 2. Varicella zoster virus
b. Herpes labialis
__ 3. Human herpes virus-8
c. Kaposi’s sarcoma
__ 4. Herpes simplex virus-1
d. Burkitt’s lymphoma
16. A 50-year-old man who smokes a pipe is found to have lesions on his palate, underneath
his denture. He says he removes the denture only to clean it. The lesions on his palate
are erythematous, papillary projections. His chief complaint is an ill-fitting set of
dentures that is l0 years old. This patient most probably has:
a. candidiasis.
b. traumatic ulcers.
c. stomatitis nicotina.
d. papillary hyperplasia.
17. The most common location for a mucocele is the:
a. palate.
b. lower lip.
c. upper lip.
d. retromolar pad.
18. A permanent tooth that displays hypoplasia caused by trauma or infection during
development has been termed:
a. “peg” lateral.
b. Mulberry tooth.
c. Turner’s hypoplasia.
d. Hutchinson’s incisor.
19. Dysplastic lesions of squamous epithelium occur most often on the:
a. palate.
b. buccal mucosa.
c. floor of the mouth.
d. dorsum of the tongue.
20. The most common malignancy in the oral cavity is:
a. osteogenic sarcoma.
b. basal cell carcinoma.
c. metastatic carcinoma.
d. epidermoid carcinoma.
ADHP Oral Pathology 2015 3 21. Dental fluorosis occurs in the permanent dentition only. It can be prevented by
restricting children's intake of fluoride during the enamel's calcification period.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, the second is false.
d. The first statement is false, the second is true.
22. Identify the three medications from the following list that can be associated with gingival
hyperplasia.
a. Inderal
b. Phenytoin
c. Nifedipine
d. Cyclosporine
23. A herpetic whitlow refers to a herpes infection of the:
a. lip.
b. finger.
c. cervix.
d. gingival.
24. Carcinoma that does not invade the connective tissue is referred to as:
a. carcinoma in situ.
b. basal cell carcinoma.
c. epidermoid carcinoma.
d. squamous cell carcinoma.
25. Recurrent aphthous ulcers:
a. are caused by a coxsackievirus.
b. appear to be associated with stress.
c. are caused by herpes simplex virus.
d. can produce an associated rise in antibody titer against herpes virus.
26. A 40-year-old man has routine dental films exposed. Upon examination of the
radiographs, an oval radiolucent area is discovered above the maxillary central incisors.
The teeth are vital, and the roots are not resorbed. This patient most probably has a:
a. radicular cyst.
b. nasolabial cyst.
c. globulomaxillary cyst.
d. nasopalatine duct cyst.
27. A radiograph shows an unerupted mandibular third molar with a 3 cm. pericoronal
radiolucency. The most likely diagnosis is:
a. primordial cyst.
b. dentigerous cyst.
c. lateral periodontal cyst.
d. odontogenic keratocyst.
28. The odontogenic cyst having the highest recurrence rate is the:
a. keratocyst.
b. radicular cyst.
c. periapical cyst.
d. incisive canal cyst.
29. Identify the four conditions from the following list that appear white on a clinical oral
exam.
a. Mucocele
b. Linea alba
c. Leukoplakia
d. Leukoedema
e. Pseudomembranous candidiasis
30. Lace-like white striae present on the buccal mucosa bilaterally may represent:
a. linea alba.
b. leukoedema.
c. lichen planus.
d. erythema multiforme.
31. What is the most common location for AIDS-related “oral hairy leukoplakia”?
a. Soft palate
b. Buccal mucosa
c. Dorsum of the tongue
d. Lateral border of the tongue
32. Patients with bulimia commonly suffer from:
a. erosion of the teeth.
b. severe dental caries.
c. gastric acid decalcification of the teeth.
d. All of the above are correct.
33. Which of the following intraoral locations is the most common site for formation of a
pyogenic granuloma?
a. Palate
b. Tongue
c. Gingiva
d. Buccal mucosa
34. Sialoliths are most commonly found during radiographic examination of (the):
a. Stenson’s duct.
b. Wharton’s duct.
c. maxillary sinus.
d. minor salivary glands.
ADHP Oral Pathology 2015 5 35. Loss of which of the following papillae occurs in benign migratory glossitis?
a. Foliate
b. Filiform
c. Fungiform
d. Circumvallate
36. Clinically and microscopically, an epulis fissuratum is most similar to which of the
following lesions?
a. Papilloma
b. Condyloma
c. Irritation fibroma
d. Giant cell granuloma
37. Which of the following teeth most frequently demonstrate microdontia?
a. Maxillary canines
b. Mandibular canines
c. Maxillary lateral incisors
d. Mandibular second premolars
38. The first clinically observable reaction to radiation overexposure is:
a. loss of hair.
b. radiation caries.
c. erythema of the skin.
d. agenesis of blood cells.
39. A specific presentation of oral candidiasis, sometimes seen in otherwise healthy patients
is:
a. hairy tongue.
b. geographic tongue.
c. benign migratory glossitis.
d. median rhomboid glossitis.
40. Stevens-Johnson syndrome is a severe form of:
a. herpes simplex.
b. lupus erythmatosus.
c. erosive lichen planus.
d. erythema multiforme.
Key:
1. b. Attrition is loss of tooth structure from tooth to tooth contact and is considered
physiologic. The pathologic form of attrition is bruxism.
2. b. The filiform papillae are the most numerous tongue papillae. When they are elongated or
hyperplastic (hyperplasia is increase in the size of an organ or tissue from an increase
number of cells) the condition is called hairy tongue.
3. a. Antibiotic therapy predisposes patients to opportunistic infections such as candidiasis.
Candida infections often present as white lesions that can be scraped off leaving a red
raw surface.
4. b. The first 2 sentences are distractors and are not necessary to answer the questions. Fordyce
granules, a normal finding, are intraoral sebaceous glands that present on the buccal
mucosa and the vermillion border bilaterally.
5. d. Epulis fissuratum (Inflammatory fibrous hyperplasia) is caused by ill-fitting dentures.
Treatment is to remove the lesion and fabricate new dentures.
6. d. By definition, concrescence is the union of teeth by cementum.
7. a. Teeth joined during development are “fused” together, hence the term fusion. Teeth that
are fused typically would look like a large tooth (a macrodont).
8. b. A tooth with a severe curve is termed dilacerated or a dilaceration. A Turner’s tooth is a
permanent tooth that has defects from an infection in a succedaneous (baby) tooth.
Hutchinson’s incisors are seen in congenital syphilis.
9. d. The mesiodens, a supernumery tooth in the anterior maxillary, is the most common
supernumerary tooth.
10. a. Pathologic loss of tooth structure from a chemical process is termed erosion. Lemon juice
is an acidic chemical and frequent use can lead to erosion.
11. c. Nicotine stomatitis (nicotinic stomatitis, stomatitis nicotina, or smoker’s palate) is
basically a callous of the hard palate and has a white wrinkled appearance. The red dots
that are seen are the orifices of inflamed minor salivary glands.
12. b. Bilateral white lesions of the buccal mucosa that disappear when stretched are called
leukoedema. These are seen more commonly in dark-skinned individuals.
13. d. Squamous cell carcinoma is seen most commonly at the posterior lateral tongue followed
by the floor of the mouth/ventral tongue. The gingiva, alveolus, hard palate, buccal
mucosa, and vestibules are uncommon locations for this cancer.
14. a, c, d. Papillary hyperplasia occurs on the hard palate and is usually caused by not taking
out a maxillary denture enough.
15. d, a, c, b
16. d. Papillary lesions under a denture that is ill-fitting or is never removed is called papillary
hyperplasia. Never removing a denture except to clean it would also predispose a patient
to candidiasis, but this would not typically be papillary. This patient is not susceptible to
nicotinic stomatitis as the denture is protective and would not allow the smoke to reach
the palatal tissue. Ulcers aren’t papillary.
17. b. Mucoceles can occur anywhere there are minor salivary glands (everywhere except the
attached gingiva and anterior hard palate). The lower lip is a common place for trauma
and subsequent mucocele formation.
18. c. This is called a Turner’s tooth or hypoplasia. This is a form of environmental hypoplasia.
19. c. Dysplastic lesions occur at the same location as cancerous lesions—posterior lateral
tongue surface followed by floor of the mouth/ventral tongue. Floor of the mouth is the
best answer.
ADHP Oral Pathology 2015 7 20. d. Epidermoid carcinoma is another name for squamous cell carcinoma, by far the most
common cancer of the oral cavity.
21. d. Fluorosis can occur in any teeth that are forming at the time of the ingestion, whether
primary or secondary teeth. If fluoride is restricted during the period of enamel
formation, fluorosis cannot develop.
22. b, c, d. Inderal is a non-selective beta blocker antihypertensive. This class of drugs does not
contribute to gingival hyperplasia.
23. b. By definition, herpes on a finger is called a whitlow.
24. a. If invasion has not occurred but the entire thickness of epithelium has features of
dysplasia, the term carcinoma in situ is often used.
25. b. Aphthous ulcers are NOT associated with a virus. The effects of stress on the immune
system is a trigger for aphthous in many people.
26. d. A cyst in the anterior maxilla may be from the most common non-odontogenic cyst in the
oral cavity, the nasopalatine (incisive canal) cyst. The fact that the teeth in the area are
vital rules out a radicular (periapical, apical periodontal) cyst.
27. b. The most common cause of an enlarged radiolucency around the crown of an impacted
tooth is a dentigerous (follicular) cyst.
28. a. Most oral cysts have a very low recurrence rate. The odontogenic keratocyst (OKC) is an
exception and it has at least a 25% chance of recurring or coming back.
29. b, c, d, e. A mucocele typically has a clear or bluish tinge.30. c. Lace-like white striae are
also known as Wickham’s striae and are seen in lichen planus. Linea alba is a single
white line along the plane of occlusion, leukoedema are white lesions that disappear
when stretched. Erythema multiforme is an ulcerative disease that often has crusting of
the lips and bull’s eye or target lesions on the skin.
31. d. OHL occurs on the lateral tongue surface. Severe lesions can wrap around to the dorsal
surface.
32. d. All answers are correct. The erosion seen is from gastric acids. Bulimics often ingest
high sugary foods and chronic bulimia can lead to xerostomia both of which contribute to
a high caries rate.
33. c. Pyogenic granulomas can literally occur anywhere in the body, but intraorally are most
commonly found on the gingiva.
34. b. The long tortuous route of the submandibular (Wharton’s) duct along the floor of the
mouth make this the most common location for sailoliths (salivary stones).
35. b. The most numerous papillae on the tongue are the filiform and these are lost or
desquamated in benign migratory glossitis (geographic tongue, erythema migrans).
36. c. An epulis fissuratum forms around the flange of an ill-fitting denture and is essentially an
irritation fibroma.
37. c. Microdontia occurs so frequently in the maxillary lateral incisor that we give it a special
name (peg lateral).
38. c. Radiaton overexposure is like getting a sunburn and erythema of the skin is the first
reaction.
39. d. Median rhomboid glossitis (central papillary atrophy) is caused by Candida albicans and
is often seen in folks with a normal immune system. Pseudomembranous candidiasis
(thrush) is typically seen with immune suppression. Geographic tongue, also knows as
benign migratory glossitis, is not caused by Candida.
40. d. Erythema multiforme is an unusual immune system response to something, typically a
virus (HSV), a drug, or a food. Severe reactions are called Stevens-Johnson syndrome.